Advice for an 85 year old

[Pellice]

I have an 85 year old single female childless friend. She is still mobile and in reasonably good shape, drives, has no apparent issues with dementia, and is sensible and cooperative. She has middle class resources.

But she knows she cannot remain indefinitely in her current home, which has 3 levels, and in which she already has problems with the stairs.

She wants to think through her situation and decide on some next steps. Could anyone point me to a website which she could use to make a start on these decisions? Something like "Questions to ask"? She is capable of doing some research on the web, although not really internet-savvy. And she is an educator, so I know that would be her preference, to do *some* research on her own before talking to someone.

I know she probably needs to talk to someone ultimately, but she'd feel better armed with some research first. Even whom to talk to - she's not in a penniless situation where she needs to find a place to go immediately, she has time, but neither is she rich enough to just contact some great luxury place and tell people to "handle it."

She has family, nieces and nephews, but not nearby, and that would be one of the questions - move, or find someplace nearby, where she still has a church and a social life. (The church really doesn't have access to the informational resources she would need.)

Sorry for the length of this, but it might be educational for others of us. Here's somebody who is willing to think ahead and be sensible about her aging situation, but where to start?

 

[Dash man]

We have three parents ages 86, 87 and 94. Two are in memory care and one lives with us.
It sounds like your friend would be okay with an independent living facility. They typically provide a couple of meals per day and activities for the residents to participate in. They usually include weekly maid service and daily checks. Some have doctors one day a week and transportation to shopping. They may also have assisted living and memory care levels if she would need more help later. Fewer have full skilled nursing care, and some take Medicare but not all.

Research online is difficult because they’re all selling and want her personal information. They usually don’t share prices online, at least until they get your information. They may then call regularly.
The places that say they’ll find a place for you like “A Place For Mom” are notorious for badgering people.

Referrals from friends and relatives is a great way to find a place. If that doesn’t work, she may have to visit some places to learn more about them. Taking someone with her is important.
I’ve found church affiliated homes are nicer. I occasionally help at a Catholic communion service at a local retirement home affiliated with my church.

They sometimes offer special deals that can be locked in, so be sure to ask.

 

[Pellice]

Thank you, Dash man, and a quick question: Is an "independent living facility" different from an "assisted living" facility?

 

[braumeister]

We have three parents ages 86, 87 and 94. Two are in memory care and one lives with us.
It sounds like your friend would be okay with an independent living facility. They typically provide a couple of meals per day and activities for the residents to participate in. They usually include weekly maid service and daily checks. Some have doctors one day a week and transportation to shopping. They may also have assisted living and memory care levels if she would need more help later. Fewer have full skilled nursing care, and some take Medicare but not all.

Research online is difficult because they’re all selling and want her personal information. They usually don’t share prices online, at least until they get your information. They may then call regularly.
The places that say they’ll find a place for you like “A Place For Mom” are notorious for badgering people.

Referrals from friends and relatives is a great way to find a place. If that doesn’t work, she may have to visit some places to learn more about them. Taking someone with her is important.
I’ve found church affiliated homes are nicer. I occasionally help at a Catholic communion service at a local retirement home affiliated with my church.

They sometimes offer special deals that can be locked in, so be sure to ask.

This was a good answer.

My mother went into a place like that when she was in her 80s. Reluctantly at first, but after a week she started giving me grief for not telling her about it years ago. They can be quite nice, and price ranges are all over the place, depending on your location.

Besides visiting and getting a tour, it's usually possible to spend a bit of time there chatting with the current residents. They also sometimes offer to let prospective residents spend a couple of nights there and have a couple of meals.

 

[Dash man]

Thank you, Dash man, and a quick question: Is an "independent living facility" different from an "assisted living" facility?

Yes, assisted living, also known as personal care, is a higher level of care, but not as high as a full nursing care facility.
My MIL has been in assisted living for years. It is more expensive than independent living. They manage medications for a price. Assist with mobility issues and memory care. They’ll change adult diapers if needed and assist bathing if needed. It is not covered by Medicaid, but is a step before full nursing care.

 

[nwsteve]

She might also check with your local senior center for resources. Senior housing options are widely varying in offerings and there are a lot of players who participate in pretending to help but mostly interested in their commission. What geography is looking at?
As a FYI, senior living options beyond aging in place are Independent Living (structured communities usually 65+ with a variety of services and meals; assisted living--more structured communities with smaller living units and professional help on site providing daily assistance with daily life skills including medication management, and at the most intensive (expensive) level, skilled nursing which provides clinical care for residents--eg administration of IVs, extensive PT (stroke recovery), early stage memory, recovery from serious falls, staffed with RNs and usually a doc on call but often in building etc.

 

[disneysteve]

My mother, who is nearly 91, moved into a senior apartment home run by the Jewish Federation about 15 years ago. It's a 5-story building but of course her apartment is just a single floor, which is just what your friend would need.


Because the rent is subsidized based on income, my mom is actually spending less to rent than she was when she owned her own home even though the house was paid off. Taxes, utilities, and maintenance still cost her a significant amount in the house.


I agree with looking into any church-based resources as well as the local office of senior resources. There are lots of options from completely independent living to places that offer varying levels of care as she ages and needs change. Some places have all sorts of activities. Some are simply apartments and you're on your own. My mom's place (pre-COVID) has bingo, movie nights, speakers, arts and crafts, regular bus service to the supermarkets and elsewhere, entertainment, holiday parties, etc.

 

[chris2008]

If possible, she should do a week as guest in some places, to get a feeling for it, for the activities and people.
It helped my mom so much before she took the decision.

The best would be a place where she could develop from independent living to assisted living and more care in her apartment so that she would not have to move again if her health declines in future.

 

[38Chevy454]

Sounds like your friend is a prime candidate for a CCRC (Continuing Care Retirement Community). She can move at first to an independent living type apt, where she does all her cooking and cleaning. They have activities, shopping trips on the CCRC van/bus, and she can even have her own car for this level. Then to the assisted living where she might have the food and maid services, typically go eat in a common area. Can still have the option for activities and the shopping, along with help for medical needs. Then if needed to higher level care. All at the same place, once you get in and are settled, they take care of you even if you run out of money and become medicaid.

 

[pb4uski]

My 90-yo DM just moved into assisted living on Monday. The facility seems more like a hotel, with lots of common areas for lounging, dining exercise room, entertainment room, activities room, a beauty salon, etc. They even have an artificial putting green on one of the two outside patios.

Her "room" is 328sf and includes a kitchenette, a large bathroom with walk-in shower and a 11'x15'9" living/bedroom. They also have loads of activities. So far she really likes it.

She is at the first of four levels of care... with level four being just a tad below nursing home care as I understand it. IIRC the cost is ~$3,500-4,000/month and each additional level adds ~$400/month. About 1/4 of the facility is dedicated to memory care.

 

[Bamaman]

I would certainly suggest her going into a quality assisted living apartment.

My parents had to move where my sister lived so she could manage their complicated healthcare. And I had to shut down their main house and move all their personal belongings.

Then I had to do the same thing for my widowed aunt who told everyone her nephews kidnapped her and brought her to this awful place--a great apartment. She had a huge house full of furniture and "stuff."

It seems like I spent the first 5 years in ER moving them both from place to place to place. I wouldn't wish that off on any of my kids.

At one point, it's time to scale down greatly. Our children just don't have the room for so much additional furniture and a full cabinet shop.

 

[Pellice]

Thanks for all the good information! There are good senior resources in New Jersey. It's just that you have to know the lingo.

Bamaman, your point about not moving around frequently is very relevant. I can see how that would happen and would be very disorienting.

Something I am very aware of is that it matters to not wait too long in making these moves. Right now, she could enjoy independent living and keep it going for a good while. If she waits for a crisis, that wouldn't be good.

 

[ImThinkin2019]

We just helped my wife's parents move into an independent living facility in Worcester, MA. Very nice place - 2 bedrooms, 2 bath, den, living room, functional kitchen. 1 meal per day provided. Underground indoor parking, phone, internet all included. Less than $4,000/month. Not a CCRC, though, but did require about $250K deposit, most of which is returned when they leave.

The facility is a privately owned group of 2, both near Boston.

We looked around where we are (Farmington, CT), and we saw other places from about $4,800-$7,000 for a couple. Some were CCRC and others were pay as you go. For the CCRC's typical deposit was about $250K also.

Most of the places let you stay in a guest apartment for like a month without comitting.

We found them all by googling, looking at the website, then calling to visit. Can't tell by the websites what they are really like - need to go there to get a real sense.

Best wishes to your friend!

 

[Calico]

There is a lot of good advice in this thread for the OP.

OP, you mentioned needing to understand the "lingo" which jogged my memory that another poster provided a very helpful post a few years ago covering "FAQs about CCRCs." Perhaps you will find that thread helpful too. The links in that thread might help your friend with her research.

https://www.early-retirement.org/forums/f47/ccrc-reference-material-faqs-86124.html

Good luck. Your friend is lucky to have you on her side!

 

[Lewis Clark]

Most, if not every state conducts annual inspections of nursing homes and assisted living facilities. May be a good idea to check the results for any facility you are considering. Search the internet for "state survey for nursing homes" or "state survey for assisted living" in your state.

 

[Buckeye]

Always make sure you take in a meal while visiting. Meal quality and the quality of the dining experience are very important.

 

[Teacher Terry]

My aunt just moved into assisted living at 95. At 90 she hired cleaners and quit cooking. My mom lived in her apartment until a week before she died at 89. A good friend of mine just bought a condo at 76. I wouldn’t move to a different town at that age where it’s more difficult to make new friends. It sounds like she has a decent social life where she is.

 

[Bamaman]

We just helped my wife's parents move into an independent living facility in Worcester, MA. Very nice place - 2 bedrooms, 2 bath, den, living room, functional kitchen. 1 meal per day provided. Underground indoor parking, phone, internet all included. Less than $4,000/month. Not a CCRC, though, but did require about $250K deposit, most of which is returned when they leave.

The facility is a privately owned group of 2, both near Boston.

We looked around where we are (Farmington, CT), and we saw other places from about $4,800-$7,000 for a couple. Some were CCRC and others were pay as you go. For the CCRC's typical deposit was about $250K also.
Most of the places let you stay in a guest apartment for like a month without committing.

Those big deposits on CCRC's are necessary to (1) keep out those that truly cannot afford the place and (2) so the CCRC can be assured that they won't go in the hole in case the resident runs out of money, goes into nursing care.
They get stuck with taking social security and Medicaid that doesn't cover the costs.

My mother paid $177K cash deposit and we received 90% back at her passing. 24/7 help to watch her for a couple of years wiped out her cash and she was down to $5,000 at the end. It was $2,050 per month with 20 meals a month in the nicest restaurant in the city. It tickled me when the ladies took the Dutch chef and taught him how to cook cornbread the southern way.

 

[teetee]

Have camera based system installed for relatives to check in. Yes it invades privacy and yes being monitored without knowing is definitely not ideal. But accidents happen and cams are the best way to know the situation for immediate response.

My 97yr old grandfather is losing his marble. He doesn't have short term memory after his last stroke in last December and his ability to tell time and surroundings is also compromised. I just told him to go to bed at 3:00am when he was cooking and making loud noises in his assisted living apartment. Soon he will have to move in with us because he could no longer live by himself safely.

I hate to say it but it is only the matter of time when one's mental status deteriorates at that age. I wish your friend enjoys the remaining few years of independence left.

To my grandfather's neighbor, he is a nuisance now. He is like a kid who does what he wants. You can't reason with him, you can't force him, and everyone around him has reduced quality of life from taking turns not sleeping just to make sure he won't burn the apartment down. In senior housing, there should be a timer to shut off the stove and electricity to the kitchen after midnight.

 

[harllee]

My 90 year old mother lives in a CCRC (Continuing Care Community) and has lived there about 10 years. She is in an independent living apartment. She loves living there even though there were shutdowns during the worst of the pandemic. She has a nice one bedroom apt, 2 meals a day included, housekeeping and utilities included. She has an emergency button she wears and there is a nurse on call right down the hall. There is a bus to take you shopping and many activities (the activities were shut down for the pandemic and are reopening now). The facility has assisted living, memory care and skilled nursing if she ever needs it.

It was expensive to move in--she opted for the less expensive no refund plan and the move in fee was around $100,000 (would be more now). I think her monthly fees are around $2500. It is full and there is a waiting list.

DH and I are on the waiting list for a CCRC in our area. Most CCRCs in our area have a 10 year plus waiting list.

 

[pb4uski]

...In senior housing, there should be a timer to shut off the stove and electricity to the kitchen after midnight.

No stove tops allowed in DM's assisted living facility... one even needs to be assessed to have a microwave in the room... she only has a mircowave and coffeemaker.

 

[teetee]

No stove tops allowed in DM's assisted living facility... one even needs to be assessed to have a microwave in the room... she only has a mircowave and coffeemaker.

Yeah my grandfather just had a microwave accident a few weeks ago. He was setting the time on the microwave and got a phone call. After the phone call he re-entered the minutes but did not reset the digital control first. Whatever that was edible became charcoal and something melted inside the microwave. It is no longer safe to use.

He would only heat thing up with a rice cooker now. The stove is strictly for boiling water.

Had it been an analog dial he would not be able to make that mistake. But microwave like that is no longer made.

 

[ImThinkin2019]

Always make sure you take in a meal while visiting. Meal quality and the quality of the dining experience are very important.

+1+1+1 on this!

Two of the places we visited gave us food to take with us. One was soup and bread, which were pretty good.

The other was an apple pie in a box with a label that said "my mother's recipe". It had some sort of whitish ooze added that was between the canned or frozen apples. We could not identify it, found it repulsive, and ended up feeding it to the chickens. And that was one of the more expensive places. (We would not have gone there anyway because the rooms were too small to begin with then hybrid split heating systems were put in which protruded into the rooms, making them even more cramped.)

 

[Sunset]

My aunt just moved into assisted living at 95. At 90 she hired cleaners and quit cooking. My mom lived in her apartment until a week before she died at 89. A good friend of mine just bought a condo at 76. I wouldn’t move to a different town at that age where it’s more difficult to make new friends. It sounds like she has a decent social life where she is.

One nice thing about all the assisted living places and the one CCRC that I visited while looking for a place for my 95 yr old relative, was the socialization.
Many are like entering College, lots of other folks to talk to and become friends with. Certainly not everyone will be a friend, but that is life.
The issue with staying in one's own home, is friends come by less often, and then cannot come by any longer due to ailments/walking/etc.

Of course for my 95 yr old relative, he had no friends as they were all dead. In an assisted living place he could have made new friends with the young 85 yr olds around there.

 

[Sunset]

Yeah my grandfather just had a microwave accident a few weeks ago. He was setting the time on the microwave and got a phone call. After the phone call he re-entered the minutes but did not reset the digital control first. Whatever that was edible became charcoal and something melted inside the microwave. It is no longer safe to use.

He would only heat thing up with a rice cooker now. The stove is strictly for boiling water.

Had it been an analog dial he would not be able to make that mistake. But microwave like that is no longer made.

We got Dad an electric kettle, the kind with a base so you can pick it up without cord so no plugging/unplugging, and it was cool to the touch so won't burn yourself from the outside, came with autoshut off.